Tuesday, 18 November 2014

Power and participation Part 2

by Jane Cooke

Last week Jane wrote the first of two blog posts on power and participation. This week we follow up with Part 2.A long time ago I went on some race equality training. The trainer opened the first day by saying: “You can’t learn from someone who you feel is inferior to you," or words to that effect. That gave me a lot to think about. I wonder if it’s a challenge to lay down now to the many people who make decisions over and about what/who to ‘do to’, and who are also saying, in just about every report one reads, ‘we need to ensure effective participation’.

In our trainings and professional and personal development we don’t give enough time to considering the ‘other’; we gather around ourselves our professional identities, our roles, our pride in our achievements and positions. And, one way and another, we end up thinking about ‘them’ and often how to change and improve ‘them’. What we share, what we can learn from true openness, from open-hearted listening, is rarely in the frame.

In the realm of mental health there is another dimension. Do we question, think about and examine what we feel about the experience of ‘madness’, what we think about people who we categorise as ‘ill’? We are, I believe, still influenced by deep seated ‘folk’ theories about madness. Moral degeneracy had currency not so long ago. If you think that underpinning belief has gone, think about some of the notions that drive the endless, fruitless, search for medical markers, genes for ‘mental illness’. There is often an underpinning assumption that if such things can be found, we will eradicate them, the genes, the carriers, the ‘bad’ foetuses. In my book that’s eugenics. (I’m not anti-abortion by the way or condemning individual decisions about terminations, it’s the broader, unrecognised societal views that I’m saying are not questioned). Didn’t eugenics die out with the Nazis? No. And it’s not just the domain of the far right, do a search around modern eugenics and you’ll find plenty there. I’m hoping you’ll find it chilling. I do.

We still, as a society, think of those ‘other’ people with characteristics, behaviours, ways of organising thoughts and experiences, as ‘flawed’. Intergenerational shame was (is?) an explanation. Or how about genetic flaws? I heard, about 10 years ago, a senior medical professional declare the view that the explanation for there having been three psychiatric hospitals built around Bridgend was that this was to meet a need generated by a flawed local gene pool. Seriously. As far as I can see there hasn’t been much of a sea change to counter such views.

I hear quite often references to people’s ‘condition’; sometimes there is a reference to someone being a ‘service user’ – a code quite often for ‘difficult’, a way of saying it’s them who is at fault because they are (lowered tone) mentally ill. Not us for having a closed mind, for not being able to manage the discomfort of difference, of challenge to our cherished views.

Many people who use, willingly or otherwise, mental health services have had very difficult life circumstances. Sometimes they, and services, know what these are, sometimes they don’t. Sometimes it is more a case of a slow accretion, many compounding experiences. We know this statistically. We know it anecdotally, we know it empirically. But then there’s a gap in our thinking. We don’t seem to think “How can we adapt ourselves, our views, our ways of working that acknowledges that range of experiences, those various views and understandings of life in order to best share power, to best truly design services with citizens and service users. We say: to join us in our territory you must behave like we do, you must follow our codes (which by the way include the view that you are other, inferior, flawed, suspect). We offer training to ‘them’. Training is very good, personal and professional development is very good; but for all of us. Some people might need to skill up in one area, some in another, whoever they are; everyone brings something of value that others can learn from. There doesn’t, however, seem to be a view that there is a need, let alone a joy, in learning and developing together. There are a bunch of people who are seen as deficient until they know how to play the game. (Then they’ll be seen as a-typical).